Rural Health Information Hub Latest News

HRSA to Eli Lilly About 340B Changes: at a Minimum, Insensitive and Potentially Illegal

HRSA’s Office of Pharmacy Affairs posted on its website a letter to Eli Lilly dated Sept. 21. While this letter does not state definitively that Lilly’s refusal to allow 340B-priced drugs to contract pharmacies is illegal, it states that HRSA has not yet made a final decision regarding its legality. Referring to Eli Lilly’s “unilateral policy” to “scrap 340B pricing to contract pharmacies,” the letter states that “although the Health Resources and Services Administration (“HRSA”) has significant initial concerns with Lilly’s new policy, it continues to review that policy and has yet to make a final determination as to any potential action…. Lilly’s decision to interpret HRSA’s responses as tantamount to definitive agency agreement with Lilly’s position is incorrect.” The letter lists four concerns about Lilly’s actions that are not directly related to the 340B statute. The letter also notes that “the timing of your pricing changes is, at the very least, insensitive to the recent state of the economy.” HRSA’s letter concludes by stating that a lawsuit by HRSA against Eli Lilly is “a potential consequence in the event that Lilly knowingly violates a material condition of the program that results in over-charges to grantees and contractors.” NACHC and PACHC will continue to monitor this situation closely.

Pennsylvania Unemployment Rate Drops to 10.3 Percent in August

Pennsylvania’s unemployment rate dropped by 2.2 percentage points in August, settling at 10.3 percent as the state continues to plot an economic recovery after the coronavirus ushered forth record-high unemployment earlier in the year. The economy added over 59,000 nonfarm jobs last month, with unemployment down by 144,000 and employment up by 86,000, according to the state Department of Labor and Industry.

Pennsylvania Supreme Court Weighs in on State Election Law Changes

The Pennsylvania Supreme Court handed down several voting-related decisions last week. The court extended the deadline for accepting mail ballots, will allow voters to submit their ballots through drop boxes and removed the Green Party’s candidate for president from the ballot. 2020 is the first year Pennsylvanians have the option to vote by mail without needing to specify a reason. The Pennsylvania Department of State says nearly 2 million people have already asked for mail ballots for the upcoming election–and that figure is expected to grow. PA voters must register to vote by Oct. 19 to be eligible to vote in the Nov. 3 election. PA residents may register to vote online.

Medicare Finalizes Two New Specialty Care Payment Models

Last week, the Centers for Medicare & Medicaid Services (CMS) finalized two new mandatory Medicare payment models.  The Radiation Oncology Model (RO Model) creates a bundled payment system that is the same for all providers of radiotherapy treatment, regardless of whether care occurs in an outpatient department or in a physician’s office. The End-Stage Renal Disease (ESRD) Treatment Choices Model (ETC Model), part of the Federal Advancing Kidney Health Initiative, adjusts payments to ESRD facilities based on the availability of home dialysis programs and the reduction of kidney transplant wait times.  Each model begins January 1, 2021.  Read more here.

Payment for COVID-19 Testing for Nursing Facility Residents

This flowchart from the Centers for Medicare & Medicaid Services (CMS) guides providers on how to bill Medicare for COVID-19 testing for beneficiaries in skilled nursing facilities/nursing facilities.  It also includes resources and explanations on how to receive reimbursements for testing if residents have Medicaid, private health insurance, or no health insurance.  Find more information here.

Request for Information:  Quality Measures for Medicaid Home and Community Based Services (HCBS) – October 19

The Centers for Medicare & Medicaid Services (CMS) seek public input on the potential benefits and challenges of using a nationally available set of quality measures in the delivery of Medicaid-funded HCBS.  HCBS programs vary by state and serve a variety of targeted Medicaid enrollees, such as people with developmental disabilities, physical disabilities, and/or mental illness, and provide opportunities for Medicaid beneficiaries to receive services in their own homes and communities rather than in institutions.  Read more here.

Comments Requested: The Role of Telehealth in Improving Quality and Access to Care – October 9

The Physician-Focused Payment Model Technical Advisory Committee requests public input on the role that telehealth can play in new physician payment models.  This committee reviews and recommends payment models proposed by the public to the Secretary of Health and Human Services, and they have posed several questions in this RFI to improve their understanding of how telehealth is used in value-based care and how it can be improved.  Find more information here.  Email comments to

New Report on Post-Acute Care in Rural America

This week, the National Rural Health Resource Center released findings from their May 2020 Virtual Summit, which focused on the issues, challenges, and strategies related to the integration of acute and post-acute care in rural areas.  The report covers the current state of rural post-acute care, including the impact of COVID-19, and explores strategies and tactics to address key issues, such as payment, workforce, and community care coordination. Read more here.